One-time injection of cortisone - no obligation to provide information and clarification?
June 12, 2017 | 40,00 EUR | answered by Dr. med. Ive Dr. Schaaf
I have a question about cortisone and the doctor's duty to inform and educate. I admit, I always react with a little fear to the word cortisone.
I went to my GP due to acute back pain. I work physically and needed a sick note and pain medication for a few days. I then received two injections in the gluteal muscle, one was, I believe, Diclofenac, and the other was cortisone. However, I only found out afterwards that one of the injections contained cortisone. Isn't it the case that the doctor or the medical assistant must inform me beforehand before administering cortisone? It's not like my pain was unbearable, I just couldn't work because I was not very mobile. I always thought cortisone was only given in emergencies or at least when the pain is unbearable, which was far from my case.
Honestly, I'm a little annoyed by this. What do you think? Can this one cortisone injection into the muscle - I unfortunately don't know the amount - have side effects such as increased blood pressure, blood sugar, or intraocular pressure? Or does it naturally decrease after a single use? Does the doctor not mention the cortisone because a single injection into the muscle is actually harmless?
Thank you in advance.
Best regards,
Hello, the administration of a pain reliever and a cortisone preparation is a very proven approach. The administration of cortisone is the "anti-inflammatory part" of the therapy, as back pain usually involves nerve irritation, which responds very well to the most effective anti-inflammatory agent we have - cortisone.
The single administration is of course not always completely free of side effects, for example, it can lead to a temporary increase in blood sugar in diabetics, which the doctor usually informs the patient about. Apart from that, the administration of a small amount of cortisone is usually well tolerated, and the doctor weighs the risks against the benefits for you in this case.
For most patients, it is important that the doctor knows what he is doing and they are not interested in what is in the "pain injection" given to them by their doctor. Whether this is good and right is the question. If you go to the hospital, for example, you will receive abdominal injections and possibly a little box of tablets, of which you do not know the name or the mode of action, but the nurse will tell you "You have to take this, the doctor ordered it.".
If you involve a lawyer and go to court, they will probably agree that the doctor should have informed you. However, this is not practical. In the doctor's office or during a home visit, there is usually a discussion about what will be done and you consent by allowing the procedure to take place, for example, during a vaccination. Who reads the package insert of the medication before a vaccination or an injection?
To my knowledge, your question cannot be answered as clearly as you would like. Especially since it is not clear what exactly your doctor has said to you. If, for example, he said "You will receive something for the pain and something for the inflammation or nerve irritation", then he has informed you to some extent.
I am not aware of any judgments stating that the doctor is obligated to give the patient the package insert to read before an injection. However, this will surely change in the future, as the above-mentioned patients ("the doctor should do what he thinks is right") are becoming fewer and more informed patients like you are increasing.
A judge could of course also ask why you did not inquire about what you were going to receive before the injection, as then the problem would not have arisen. If you have an aversion to cortisone, it would be advisable to communicate this aversion or skepticism so that the doctor has the opportunity to discuss this issue with you at the appropriate time.
I hope these explanations have helped you, if not, please ask for further clarification.
Get well soon,
Dr. Schaaf
